Properly disposing of certain kinds of waste often involves medical waste incinerators. Due to stringent environmental laws, they must adhere to federal and state guidelines that dictate exactly what type of waste needs to be incinerated and how medical waste generators need to go about storing, transporting, and disposing of that waste. If you're unaware of these laws—or simply misunderstand their rules—you are still liable to face fines for non-compliance. Therefore, it's important to know everything you can associated with the medical waste incineration process.

01   /  What Is a Medical Waste Incinerator?

A medical waste incinerator is found in many hospitals and other medical facilities. They are designed to burn certain types of waste produced in healthcare scenarios, such as infectious or ‘red bag’ waste. Medical waste incinerators might also be used by such a facility to dispose of non-infectious waste. Today, medical waste incinerators must stay within the guidelines of federal and state limitations regarding stringent standards for emissions.

In the world of generated medical waste, two of the most common disposal methods for medical waste are incineration and autoclaving. In general a medical waste autoclave runs at about 300 degrees (Fahrenheit) and sterilizes items through heated steam, while an incinerator runs at 1,800 degrees.

When waste material emerges from an incinerator, all that is left is bits of residue—also sometimes referred to as ash or dust. Medical waste autoclaves, however, may leave items still generally intact though sterilized upon completion of the process.

The most common type of medical waste incinerator is the controlled air unit. Waste combustion occurs in two stages and results in residual carbon waste in the burned ash. Temperatures in such incinerators range 1,400°F to 1,800°F. Today, emissions of waste particulates such as carbon monoxide, acid gases, nitrogen oxides, and other materials are carefully monitored.

02   /   What Kind of Waste Needs to Be Incinerated?

Not every type of generated waste requires incineration. However, if a waste generator produces (or thinks they are producing) the following types of wastes, incineration should be part of your waste disposal strategy:


Trace chemotherapy waste


Pathological waste, including body parts and other biological tissues


Some types of hazardous waste

Red bag medical waste (bloody or otherwise contaminated materials, such as gauze, bandages, gowns, sharps, and so on) do not require incineration. Rather, these go through the autoclave process.

Note that trace chemotherapy and pathological waste streams are technically regarded as "regulated medical waste." However, they are not disposed of in the same manner as red bag waste.

03   /   What Happens to Medical Waste after Incineration?

While incineration of certain types of medical waste is a critical step in the waste disposal process, it's not the last one. After the incineration process, the resultant dust or ash must be shipped to an authorized and approved landfill that is intended for non-hazardous waste.

Not all landfills are created equally. For example, the Environmental Protection Agency (EPA) regulates landfills under the purview of the Resource Conservation and Recovery Act (RCRA) under Subtitle D (solid waste) or Subtitle C (hazardous waste).

Following incineration, medical waste is deemed non-hazardous, and so is then transported for disposal in a Subtitle D landfill. Following the incineration process, a certificate of destruction can be obtained. These can be obtained from state waste management programs. This document is also handy to have in the event you are ever audited or need to otherwise prove that a particular waste stream was properly disposed of.

04   /   Common Mistakes Related to Medical Waste Disposal

Some facilities, in an effort to be better safe than sorry, send their red bag waste to incineration. This is unnecessary and costs needless expenditures of money. An autoclaving machine renders all red bag medical waste perfectly safe for disposal. Such knowledge is only one reason working with a medical waste management company can benefit any facility producing red bag waste, and is both cost effective and maintains compliance.

However, be aware of the difference between hazardous and non-hazardous pharmaceuticals. A waste generator may end up simply incinerating all pharmaceuticals that require disposal in an attempt to ensure compliance. While this is an acceptable (and safe) method, it does contribute to high (and unnecessary) medical waste disposal costs. Working with an experienced and knowledgeable medical waste management company can help you identify what needs to be incinerated and what does not.

This is not, however, a place to cut corners or take chances. The risks and resulting fines associated with improperly disposing of waste that is intended for incineration are steep. Consider working with a waste disposal professional to maintain compliance and reduce the risk of fines for improper medical waste disposal practices.

05   /    When do State Laws apply with Medical Waste Incineration?

In general, federal law dictates what you must incinerate and how you must legally go about that. Every state is required to meet the minimum stipulations as set out in those federal laws. However, that doesn’t mean that any given state can’t be more stringent than overarching federal laws require, and they often are.

For example, some states require that waste destroyed though an autoclave machine be subsequently shredded after sterilization. Other states, such as Georgia, don't require such steps and are yet fully compliant with all federal regulations.

This is yet another important reason to reach out to a local waste management company. If you're a medical waste generator and unsure of all federal and state laws to which your facility or business is held accountable, professional advice can offer peace of mind and savings.

For more information about how incineration works or what types of waste are better off incinerated, contact a representative of MCF Environmental Services, a waste management company located near Atlanta, Georgia. We provide customized services for medical waste management throughout the U.S.

Robert Losurdo

President, COO